Permit r CITY OF TIGARD ELECTRICAL PERMIT
rr
PERMIT #: ELC2006 -00497
DEVELOPMENT SERVICES DATE ISSUED: 9/1/2006
°� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 CC -07900
SITE ADDRESS: 15805 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT : 106 JURISDICTION: TIG
Project Description: Verizon Duplex: replace damaged main service feeder cable. Job # 1555.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PEGGY GIANELLI CONDUIT ELECTRIC
15805 SW GREENS WAY 19461 SW 89TH AVE
TIGARD, OR 97224 TUALATIN, OR 97062
Phone: Contact #: PRl 503 692 - 1428
FAX 503 - 692 -3652
FEES
Description Date Amount Reg #: ELE 26 -905C
[ELPRMT] ELC Permit 9/1/2006 $80.30 LIC 109669
[TAX] 8% State Surcharge 9/1/2006 $6.42 SUP 45015
Total $86.72 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: ,Z4 i_1'z Permittee Signature: cS jug._
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503- 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
2006 /SEP /01 /FRI 10:58 AM Conduit Electric FAX No,5036923652 P. 001
\w . . I
Electrical Permit Ap icatit firVE O FOR OFFICE UUSF ONLY .
Pa tl i Tigard, 01 Rcotived �)
City of Tigard batt " D !f Permit � ltit i�
13125 SW Han Blv d., 2 97223 1. 2 P ian R eview
5 E P 0 :.ns.h Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 r lrliwi,i I • l�
Inspection Line: 503,639.4175 r .1 {, ' d !t
Internet: wvnv_ci.tigard.or,es CITY O DIVISIO �__�,�- Date Rea/
A1otifledlMeu d. Supplemental information
Page BUILDING DIVISIO
%:c 1 .
r �R�
0 New construction Addition/alteration/replacement Please chock all that apply:
El Service over225 amps, oomm'l 014a7ardous location
❑ Demolition Other: [] Service over 320 amps— rating ❑ Buildng over 10,00 8.,
•,, ; i�� . 'i•!. q:; . ; ;' � ••'�' it dwellin s 4 or more new esi Q sq.
,: - ,,,.: „ :•; :,t;QAiriP4 �'y'�Q , &'li�R�,C`l'•�IWI+f•; - . : �r;' "= ':•1.,,: . �1;; ! .,..•, f•'''."••'•' of l -and 2-family y g residential • r2 1- and 2 - family dwelling ID amps structure
Commercial /industrial 0 Accessory building ❑System over 600 volts n units in one
❑Building over three stories • ❑Feeders, 400 amps Or more
• Multi- family ❑Master builder [] Other: El Occupant load over 99 persons ❑Manufactured structures or
;: ,;rw ! % iar; :';4 ; E ess /1i htin an RV park
< ,',4 =:' o 'SILT ;ra ..: RMAmY N` .;tX.Apig40N , : ❑ P 8 g p
;.; ; "i. :ii% (' + ' ■ , ealth -care facility UOther:
Job no.: 5 S lob site address: 1 - - t� 4 • . .mit 2 sots o p w any of the above.
. - le above not applicable .
ve are pplicable to temporary construction seryiee
citristate<z�: i ; � .„...4, 1 .. — .. , , : , . .. .: ,. •. ,.
l` °i�,`r: ,�!�� {. .:1"Y' < r ?. i 5 11. s+F{+!�,:f'+- 'i� W:,, r , lk'4.. >,• :':.: ..t .iu "
Suite/bldg. /apt. no.: Project name: U ,1 I Dee lg. I Q'v I Fed I Torsi I "'
Cross street/directions to job site: 0 Newresiilentlal single - or multi - family dwelling unit. :
Inciudes'attached garage.
1,000 sq. 8. or less . 145.15 4
SUbdi vision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 . ' 1 • _. . _ -- Limited energy, residential 75.00 2 •
Tax map /parcel no.: ' • Limited energy. non-residential 75.00 2
,; ,, . , -♦: qr . -�. - .-:, ,-.4 i:t:� 4.•il '
; • a -.i;: �" `'1 ,:;ij ;: i'i ?i ` '•; ? , • d °ea:� < t nufactured or modular
- �� �:y: '.�.• � <�'�s- ��;���?�SCEtIP��01!l .tj]�:,;�V�VQRK; �• ::;:� s, . I Vic: "... .;�: ..� .� ^I'^ Bac ma
;,: I l dwelling, service and/or feeder • 90.90. I 2
,��, 1/ ��, . I Services or feeders installation, altel'atlon, and /or rclocr1tion
,,0o 200 amps or less I • 80.30 .:30. 2
I • , � 4 ;
< I! "� A .;. ;;;; ,; ",
: •- 1- 201 amps to 400 amps 106.85 2
''� , °!i; '•rl. ii,m..g§: ' `'ix ; :'c :;i^i�<' i' v a• : 1 T • t7 P
t1'., :r.' "aJ)<!1�Q'1�'i.:L ,:,t1 :i...r,_ 'i;C 1 :'... : 5.,..,`:; n f11 C, ;,,,..s'u''r,.,.;
160.60 "2
.. , ..:......, ...> ..:.... .:.� > , .,� . ,.,... , ,..,. 401 amps to 600 amps _
Narr A , l • \ 2. \ e Q (J \ 60I amps to 1,000 amps 240.60 2
Address: `� J Over 1,000 snips or volts . . 454.65 2
, Reconnect only 66.85 : . 2
City/State/22: Temporary services or feeders installation, alteration, and /or
• relocation
Phonc: ( ) Fax: ( ) 200 amps or less 66.85' I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: b
` Date: Branch circuits — new, alteration, or extension per panel
,W if - t s.`i s;r "'i;1i ^, 817ir.'ty .'r ?t .:•:S�A.1q, A. Fee for branch Circuits with
• c . ? i ; ;Y', � k, : 11 Tt r: s:a A.i. 1�q: . Gr O; , i u1k G : fr ji E 4 •WI :Yr :�>`nv ? .. .
... •'r;;.,:!r�"_•; :. . <.�''�'.;. ..-s �:;` , '�- . / +�: . ,, .n feeder service or f eode 6.65 2
Business name: branch circuit _
B. Fee for branch circuits • .
Contact name: without service or feeder fee, 46.85 2
._ each branch circuit
Address: Each add'I branch circuit I I 6.65 2
City /State/ZIP: . Miscellaneous (service or feeder not included)
Pump or irrigation circle • 53.40 I 2 •
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E-mail: • Signal circuits) or limited �
•
? ; s'. ,:: :∎,!., .,4 -` ;`,4- ,(r. f :,. I ;,:ig energy panel, alteration, or
;:s: ; 1 %�: emAllt ; ....
extension. Describe: Page 2 ; 2
'Business name:
• t
- Each additional inspection over allow ablc.in any of thelabove
Address: q ► 4 Per inspection 62.50
City/State/DP: ! ! n / e q-1(269 Inv stj per hour (1 hr min) 62.50
Industrial plant per hour 73.75
. Phone: (s0 ) to ; 'Fax C /a 7 E:, : 2' r 1 =? ,
'� � � i �7, � ,r,:� ';::; :��:�t� >�1;M1['C. � h S. .';:: s;�j�. -:
• CO3 Lic_• /0� , ! Electrical Lic.: (..g �iCliS V Subtotal a kwQ
Suprv. Electrician signature, required: , � '� Plan review (25% of permit fee)
State surcharge (a% of permit fee) to —
Print name: ( 3 ` ,, Date: I - TOTAL PERMIT FEE
Authorized signature: This permit appliceOOf expires if a permit is not obtnined'i hin 180
• - • days after ir has been accepted as complete
Print name: • • Date: * Fee methodology set by Tri -County Building Industry Service Board
" Number of inspections par permit allowed.
. iNf luilding %Pemlits\ELC-PermlLApp.doc 12/03 440 014/WEB • 1 •
CITY OF TIGARD '
BUILDING DIVISION PERMIT #: ELG 00&Q( ! 7
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/1/2006
Phone: (503) 639 -4171 .� a VB( �iI
Inspection Requests (24 Hrs.): (503) 639 - 4175 ±1 '.
INSPECTION WORKSHEET FOR DATE: 902005 TIME: 7 : 00A A M PAGE: 51
SITE ADDRESS: 15805 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.2 LOT #: .lQ5 TYPE OF USE:
PROJECT NAME: GI ANEW
DESCRIPTION: Verizon Duplex: replace damaged main service feeder cable. Job # 1555.
OWNER: GIANELLI PEGGY PHONE #:
CONTRACTOR: CONDUIT ELECTRIC PHONE #: 503 -£92- 1428
Inspection Request Scheduled For: Date: 9/8/2006 Pour Time:
Cod • Description Confirm # Contact # Message
199 Electrical final
t7 tl fad 03.48 598 N •
Corrections /Comments/ Instructions:
'•••/\, .
VA PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ®6s .,.. Date.: C t • 1 6" 0 b Phone #: (503) 718_11#00
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